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ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 106339380
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871 C2
City Business License #: N R-023614
CONTACT: Sue Sidick
Phone #: 425-457-6353
Fax #:
Email #: Susan.Sidick@pse.com
❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 22017 95th PL W
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
❑ Commercial ❑ Subdivision ❑ City Project ❑ Traffic Control (Only)
❑ Multi -Family ❑iC Single Family ❑ Other
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
ANY ASSOCIATED PERMITS?
❑ Yes ® No
BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area is approx 2' W c/I
to 13' E c/I of 95th PL W & 155' S c/I of 220th ST SW to install gas service (2)3x5 gravel/ asphalt cuts anticipated
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year: 1063;
PAVEMENT CUT:
CONCRETE CUT:
❑ Yes ❑ No
❑ Yes ❑ No
If yes, indicate size of cut: 3
If yes, indicate size of cut: —
x5
x
RIGHT-OF-WAY
CLOSURE
AREA
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
X
LF
SF
Alley 72 Hrs + LF
X
LF
SF
Parking 72 Hrs + LF
X
LF
SF
APPLICANT TO READ AND SIGN
*Traffic control and public safety shall be in accordance with City regulations as required by the City
Engineer. Every flagger must be trained as required by (WAC) 296-155-305 and must have certification
verifying completion of the required training in their possession.
*Restoration is to be in accordance with City codes and Standards. All street -cut trench work shall be
patched with asphalt or City approved material prior to the end of the workday — NO EXCEPTIONS.
Indemnity: The Applicant has signed an application which states he/she hold the City of
Edmonds harmless from injuries, damages or claims of any kind or description
whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or
any of its departments or employees, including defense costs and attorney fees by reason
of granting this permit.
I have read the above statements and understand the permit requirements and acknowledge that I must
follow all requirements in order for the permit to be valid.
Susan-1 1 - DI911e1�➢sl".S,dp.d by Sks P,1111 5/8/2018
I d I cK DN at=Susan 11 " ,=di,nitlin DepaNnUS ou=Muniapal
SIGNATURE D1b.201805��8133n=0 0700=e�nm �-Ds DATE
Deie: 2018.05 OB 13:38 30-0�'00'
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Job #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date
Est. Duration:
106339380
4/24/18
EDMONDS
Yes
6/25/18
Puget Sound Energy Gas Pre -Inspect Form
Address:
City / Zip:
Customer:
PM / Inspector:
22017 95TH PL W
Edmonds, 98020
TIMOTHY ROBINSON 317-417-2182
Kevin Williams 425-691-7573
Job Description / Scope of Work
From 2" main run new complete 1-1/8 PE service to single family residence (50' scat stub with
New Construction:
No
30' scat extension)
set A-250 OL @ Inches
Construction Method
All Scat / Trenchless
PLAT Map:
165.067
t
N
220th ST SW
.._._._._._._..._._._._._._._._._._._._
Fire Hydrant
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^3 10'
ROW 60'
P/L
Work Location
Size of Cut
Surface Type
2'
W
of PAV
95th PL W
&
155'
S
of CL
220th ST SW
3x5
gravel/asphalt
13'
E
of CL
95th PL W
&
155'
1 S
I of CL
1220thSTSW
3x5
gravel/asphalt
of CL
&
Iof CL
Service Information
Street Information
Job Type
Diameter:
1-1/8" PE
Flaggers #:
Arterial:
New Residential Svc
EFV:
1-1/8" - 2600 - 9999144
Police #:
TCP:
Yes
vuCEr
SOUND
FNERGY
Meter:
A250
Speed Limit:
30
No Parks #:
6
Meter Loc:
03 - OL
Trolley Lines:
Mtr Hoods #:
Del Press:
6" W.C.
Traffic Signal:
Bus Stop:
Bollards:
2.5" # 1 1 4" # I
ADA Ramps #:1
1 Route #'s:
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W20-5L
Notes:
1. All signs and spacing to conform to the
MUTCD and City of EDMONDS standards.
2. All sidewalks, driveways, exits and egresses
shall be completely clear unless otherwise indicated.
3. Channelizing devices are 28" traffic cones.
Use traffic drums (barrels) with steady burning
Type C lights on all State State Routes and Hwys.
4. Sign size can be a minimum of 36" x 36" and
shall not obstruct pedestrian access.
5. Crew is required to leave a minimum of 11' for traveling
lane width.
6. Alert affected residents and businesses.
7. Work to take place between 9 a.m. and 4 p.m
unless otherwise specified. All work for arterials
and major roadways will be from 9 a.m. to 3 p.m.
8. Work area will be 13' WCL of 95TH PL W & 155SCL of
220TH ST SW.
9. Contractor shall post temp "NO PARKING" 72 hours prior
to construction.
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009
RESIDENT(S) WILL BE
INFORMED OF POSSIBLE
TEMPORARY DRIVEWAY
CLOSURE
V3bV AVMV MOl
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MATCHLINE
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MATCHLINE
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
(425)424-6425
— -7 - � -F -
7-----------------�0�0-----
220TH ST SW
y
SEE RIGHT
MINIMUM TAPER LENGTH = L (feet)
LANE
POSTED SPEED LIMITS
WIDTHS
20
25
30
35
40
45
10
70
105
150
205
295
475
11
75
115
165
225
295
495
12
80
125
180
245
320
540
CHANNELIZATION
DEVICE SPACING
TANGENT
TAPER
MPH
80
40
55/70
60
30
35/45
40
20
25/30
0
0
CD
CD
0
LEGEND
®
28" TRAFFIC CONE
®
BORE PIT
TRAFFIC FLOW
FLAGGER
WORK VEHICLE
SIGN LOCATION
WARNING FLAG
SIGN SPACING
"X"
55 +
800
60/65
500'
45/55
350,
35/40
200,
30
100,
25
PUGET
' SOUND
ENERGY
Job#106339380
22017 95TH PL W, EDMONDS , WA
May 4, 2018
Sheet 1 of 2 gregory.harwood@pse.com
(425) 424-6425
SEE LEFT
SO
9
NE LAN
ROAD
AHEAD
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0
N
9
IN
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PLAN PREPARED BY:
TRAFFIC MANAGEMENT, INC.
0.763.3999
www.trafficmanagement.com
Traffic Control Services - Sales Rentals �TMI
Permits &Consulting Engineering Training
C31 # 785804
TMI CONTACT PERSON: Michael Flanagan
TCS CERT #: 301872
PLAN ORDER: 36578 DATE: 51412018 - MCH
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A200' 200'
44 N
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W20-1
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W20-5L
Notes:
RESIDENT(S) WILL BE
1. All signs and spacing to conform to the
INFORMED OF POSSIBLE
MUTCD and City of EDMONDS standards.
TEMPORARY DRIVEWAY
2. All sidewalks, driveways, exits and egresses
CLOSURE
shall be completely clear unless otherwise
indicated.d3ae
dMdMo�
3. Channelizing devices are 28" traffic cones.
Use traffic drums (barrels) with steady burning
JNMJVd •
Type C lights on all State State Routes and
Hwys.
4. Sign size can be a minimum of 36" x 36" and
shall not obstruct pedestrian access.
5. Crew is required to leave a minimum of 11'
for traveling lane width.
6. Alert affected residents and businesses.
MATCHLINE
7. Work to take place between 9 a.m. and 4 p.m
unless otherwise specified. All work for arterials
and major roadways will be from 9 a.m. to 3 p.m.
8. Work area will be 13' ECL of 95TH PL W &
155' SCL of
220TH ST SW.
9. Contractor shall post temp "NO PARKING" 72
hours prior to construction.
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Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
(425)424-642�
�a
C=:> MATCHLINE
-- - - - - - -- -------
220TH ST SW
1R1=T°o
TOW AWAY AREA
22017
_ SEE RIGHT
MINIMUM TAPER LENGTH = L (feet)
LANE
POSTED SPEED LIMITS
WIDTHS
20
25
30
35
40
45
10
70
105
150
205
295
475
11
75
115
165
225
295
495
12
80
125
180
245
320
540
LEGEND
®
28" TRAFFIC CONE
®
BORE PIT
TRAFFIC FLOW
FLAGGER
WORKVEHICLE
SIGN LOCATION
WARNING FLAG
CHANNELIZATION
DEVICE SPACING
TANGENT
TAPER
MPH
80
40
55/70
60
30
35/45
40
20
25/30
PUGET
' SOUND
ENERGY
Job#106339380
22017 95TH PL W, EDMONDS , WA
May 4, 2018
Sheet 2 of 2 gregory.harwood@pse.com
(425) 424-6425
SEE LEFT
O
C
Q
• o
■
N
O
r
ONE LANE
CS
ROAD
AHEAD
10110
bl4
00
ROAD
WORK oN
AHEAD
SIGN SPACING
"X"
55 +
800
60/65
500'
45/55
350'
35/40
200'
30
100,
25
PLAN PREPARED BY:
TRAFFIC MANAGEMENT, INC.
0.763.3999
www.trafficmanagement.com
Traffic Control Services -Sales &Rentals �TMI
Permits &Consulting Engineering Training
C31 # 785804
TMI CONTACT PERSON: Michael Flanagan
TCS CERT #: 301872
PLAN ORDER: 36578 DATE: 51412018 - MCH